Whether they talk about it or not, many postmenopausal women are experiencing pain during sex due to vaginal dryness and vaginal atrophy. Now, researchers say an experimental treatment may offer new hope for women wanting to continue a satisfying sex life. After only two weeks of therapy, 63 percent of postmenopausal women using a vaginal softgel capsule reported improvements to their quality of life, says new research presented at the International Society of Women's Sexual Health 2015 Annual Meeting.

“It's important that women have options when it comes to their sexual health,” said Dr. Sheryl A. Kingsberg of University Hospitals Case Medical Center in Cleveland.

Vulvar and vaginal atrophy or VVA, a chronic medical condition that results from a decrease in naturally occurring estrogen, affects many postmenopausal women. Symptoms include vaginal dryness, irritation, and most importantly, pain during intercourse. In fact, between 25 and 45 percent of all postmenopausal women complain of painful sex. Despite how common this is and how far-reaching the effects of VVA, it is both underdiagnosed and undertreated. This EarthClinic chat suggests a number of natural solutions used by women who have direct experience with this problem. Only seven percent of women use a prescription therapy, as a recent online study noted.

Studying the Problem

A 2013 survey conducted in the United States polled 56,000 postmenopausal women with VVA symptoms, and altogether 3,046 women responded to the online questions about their knowledge of the condition, the impact of symptoms on their activities, their communication with health care providers, and their use of available treatments. The most common symptoms cited by respondents were dryness (55 percent of participants), pain during sex (44 percent), and irritation (37 percent). Symptoms affected sexual pleasure and enjoyment for more than half (59 percent) of all survey respondents. About a quarter said their symptoms interfered with their sleep.

Shockingly, only 24 percent of the women attributed their symptoms to menopause, while just 12 percent listed hormonal changes. Add to that, only a little more than half of the women had discussed their symptoms with their gynecologist or another health care provider, and just 40 percent had used or tried some form of VVA-specific treatment. Women said inconvenience and poor symptom relief were major issues with the over-the-counter products. When it came to prescription therapies, women said they feared side effects or an increase in cancer risk.

Based on these results, a second research team led by Kingsberg conducted a new study involving menopausal women randomly selected to try either an experimental vaginal softgel capsule (TX-004HR VagiCap, which contains estrogen) or a placebo. Of the women using the VagiCap product, 63 percent reported an improvement in their quality of life after treatment of only two weeks' duration, compared to 48 percent on the placebo. Overall, 96 percent of respondents found the capsule easy to insert. When asked whether they preferred the capsule to previous medications, 36 percent said "very much" or "somewhat preferred," while two-thirds said they would "probably" or "definitely" consider using the vaginal capsule again.

“New treatment options — such as this VagiCap, if approved by the FDA — have the potential to improve satisfaction for these women,” Kingsberg said. “There is medical consensus that estrogen administered locally is the preferred mode of treatment for both symptom reduction and restoring and maintaining healthy vaginal tissue and sexual function.”

For women who do not want to use a hormonal product, many people recommend lubricants, vitamin E, and various unstudied herbal products. Do the research, talk to your doctor, try it for yourself. It is, always was, and always will be your body.

Source: Kingsberg SA, Amadio J, Graham S, Bernick B, Mirkin S. Patient Experience with Solubilized Estradiol Given Vaginally in a Novel Softgel Capsule (VagiCap™). Journal of Sexual Medicine. Forthcoming.